[Early diagnosis by opportunistic screening in cancer of the prostate. Results of a 1-year protocol. Comparison with historical data].
BACKGROUND
The high prevalence of Prostate Cancer (PC) and long survival of patients with advanced disease, added to the high cost of palliative treatment (hormone therapy), versus the existence of curative therapies at earlier stages, fully justify the campaigns for early diagnosis. The objective of the study was to increase the number of cases diagnosed at local stages, using an opportunistic screening methodology.


METHODS
All male patients between 50-70 years of age, seen over one year in Urology and primary care in CAP-Barceloneta because of urinary symptomatology, were included in a screening program. This cohort were performed total PSA determination and digital rectal examination. When digital rectal examination was suspicious and/or PSA values higher than 4 ng/ml, they underwent echo-guided prostate biopsy.


RESULTS
A total of 595 male were seen; 43.9% met the inclusion criteria; 39.4% were rated as suspicious, neoplasia being confirmed in 51% of these. Prevalence of PC in this cohort was 20.1%, half of them in local stage.


CONCLUSIONS
Populational screening in PC has proven to be ineffective from a health care standpoint, as opposed to opportunistic screening. Overdiagnosis was not significant, although there were more cases diagnosed in organ-confined stages, this is, eligible for curative therapy; thus, hormone therapy and the resulting morbidity were significantly decreased; quality of life of patients under curative treatment was improved; there was a large reduction of health care costs and, although it will have to be further confirmed in large multicentre series, we believe survival was improved.
Gelabert Mas
A
A
Servicio de Urología, Hospital del Mar Grup de Recerca Uro-oncològic-IMIM, Facultad de Medicina, U.A.B. Barcelona.
Arango Toro
O
O
Carles Galcerán
J
J
Bielsa Galí
O
O
Cortadellas Angel
R
R
Herrero Polo
M
M
Griñó Garreta
J
J
Foro Arnalot
P
P
Nohales Taurines
G
G
Carrasco Cánovas
N
N
D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010173:Palpation; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity
D017430:Prostate-Specific Antigen
Diagnóstico precoz por cribado oportunístico en cáncer de próstata. Resultados de un año de protocolo. Comparación con datos históricos.